How to see in the dark

After a car accident left her blind, Fred Hutch virologist Dr. Maxine Linial learned to lead her research team and continue pioneering work in the lab without sight

By Dr. Rachel Tompa

Dr. Maxine Linial

Photo by Robert Hood / Fred Hutch

From her bed in the convalescent home, Dr. Maxine Linial kept asking for her glasses.

She knew she’d been badly injured after being hit by a car and couldn’t see, but she was sure that she just needed her glasses. Repeatedly, she’d put them on only to find it made no difference, and her son, Ross, would remind her that she was now blind.

“I would say, ‘I can’t be blind, that can’t be right,’” Linial said. “But I was blind.”

At first, the virologist could see shadows and some gray blobs. But soon, that limited vision faded to black, and in the four years since, Linial has had to reinvent herself to live as a blind scientist in a sighted world.

One of Fred Hutchinson Cancer Research Center’s longest-serving faculty members, Linial, 70, is no stranger to forging her own way. She was Fred Hutch’s first laboratory-based faculty member, and for years she was the only female faculty member of what is now the Basic Sciences Division.

“I love Frank Sinatra, and especially his song ‘My Way,’” Linial said. “That’s my song. I did it my way.”

Linial has since paved the way for future women scientists. Many of Fred Hutch’s female faculty say they owe their start to Linial’s mentoring. Now she relies on her tight network of friends and colleagues to support her as she continues to lead her team, and her research field, without sight.

When she describes the research in her laboratory, Linial’s hands encircle a phantom petri dish in front of her. Her fingers flick at imaginary cells as she explains how foamy viruses, which she has studied for more than two decades, got their name: When the viruses infect cells in a dish, they kill so dramatically the cells look like they’re foaming.

Linial misses seeing those dying cells in real life. As a virologist specializing in the molecular ins and outs of foamy viruses, she got used to staring through a microscope for hours on end, examining what the cells looked like, what infections looked like. Her area of research relies on a particular laboratory technique that turns infected cells blue, and Linial specialized in counting hundreds or thousands of the blue cells under a microscope.

“Nobody else liked counting blue cells, but I liked counting blue cells,” Linial said. Now, people in her lab gripe when they have to do these experiments, she said, “and I say, ‘Oh, I wish I could count the blue cells!’”

‘I still have things to offer’

Despite her dedication to her research, a few months before the accident, Linial had scaled back her work to 80 percent and was contemplating retirement. She had a world of hobbies and wanted more time to spend on her other interests: hiking, gardening, cooking, running half-marathons, bird-watching and playing bridge. But all that fell away in March 2010.

Linial had left her house for a morning run and was en route to the Burke-Gilman Trail in Seattle when a driver ran a red light and crashed into her in a crosswalk. Observers later said they heard the passenger of the car screaming to stop, but the driver didn’t see Linial to stop in time.

Linial broke bones in her legs, hips and shoulder and suffered traumatic brain injury from hitting her head on the pavement. Her brain was so damaged that surgeons had to remove much of her skull until the swelling subsided. It was touch and go at first.

One of Linial’s doctors told her if she hadn’t been in such good shape she would have died.

As she slowly began to recover, it became clear that the optic nerve that conveyed information from her eyes to her brain was damaged and she was left in darkness. She remembers nothing about the months she spent in the intensive care unit at Harborview Medical Center, the region’s leading trauma center. Linial was visited every day in the hospital by members of “Team Maxine,” — her son, Ross, and her friends and co-workers from Fred Hutch.

“We really were very pessimistic for a while that she was never going to be close to normal again,” said Dr. Denise Galloway, Linial’s longtime friend and virology colleague at Fred Hutch, who helped Ross make medical decisions for her. “And then she just made an amazing recovery.”

Ten months after her accident, as her body healed in all the ways it could, Linial decided to return to work full time. No longer able to pursue the hobbies that used to fill her time, she threw herself into her research.

“There were so many things that she was unable to do that had been her life beforehand,” Galloway said. “The one thing she could do was the lab.”

Now, she lives with Ross, her only child, and caregivers spend the day with her to help around the house and at work. Although Linial says she thinks of the time before the accident as her “real life,” she can still be a scientist, and she is dedicated to the place where she’s built and nurtured her career over the past four decades.

“I guess I could say, ‘Well I can’t see anything and I should just slip out of science,’ but I think I still have things to offer,” she said. “I’m totally devastated by being blind, but coming to the Hutch and doing what I can is very important to me.”

Studying the what-ifs

Linial began studying foamy viruses in the early 1990s, a nearly solo venture. Very few scientists were studying those viruses at the time, and Linial continues to be a leader in the field. Foamy viruses are a type of retrovirus, the family of viruses that includes HIV, and although they are prodigious killers of cells that grow in petri dishes, there is no evidence they cause disease in humans or other animals.

Linial studies these viruses in part because of the what-ifs. Nobody had studied HIV or its close relatives until the virus mutated enough to jump from chimpanzees to humans and trigger the AIDS pandemic. It took years to understand the basic biology of that virus and many more to create working treatments. Linial wants to get a head start in case foamy viruses make a similar leap, knowing that retroviruses are prone to rapid mutation.

Linial and her colleagues found that most anti-HIV drugs don’t work against foamy viruses, so she studies how the virus grows and divides with the ultimate goal of being able to stop that growth in the worst case scenario. She’s also interested in the viruses for their unusual biology and because of the fact that they are incredibly successful invaders, having infected nearly all apes and monkeys from Asia to Africa to the Americas.

To continue her quest to unlock the secrets of foamy viruses, Linial relies on the skill and integrity of the scientists in her group.

Dr. Linial with one of the scientists on her team, Dr. Karen Craig. Craig doubles as Linial’s scientific reader, helping her review, write, and edit articles and grant applications.

“So much of the type of work that Maxine and I do is visual,” Galloway said. “To have [experiments] just described to you without actually seeing the data — it’s amazing to me that she can interpret that and make sense of that.”

Many of Linial’s team members have worked with her for years, and Linial trusts that she’s taught them well enough to work independently. She also asks probing questions about every experiment her staff presents to ensure she’s getting the full picture.

“You can’t run a lab when you can’t see if you can’t rely on the people to give you the whole story,” she said.

One of the scientists on her team, Dr. Karen Craig, doubles as Linial’s scientific reader, helping her review, write, and edit articles and grant applications. Linial also uses text-to-speech software for some of her work, which, along with her ingrained touch-typing skills, allows her to read and write emails.

“My mother always told me when I was in high school and college, ‘Maxine, learn to type, you’ll always have a job,’” she said.

Linial is frequently invited to give talks, most of which she turns down if she has to travel because flying and staying in a strange location is so difficult for her. As a testament to what she can still do, Linial was invited to give the keynote speech at the Cold Spring Harbor Laboratory 2012 Retroviruses meeting. Because she doesn’t use braille, she spoke for an hour to a large audience with no notes and no slides.

Recently, Linial and Craig have been doing a lot of writing — she’s published five papers in the past year with a sixth in the works. And, as before her accident, her junior colleagues often ask her to review their grant applications because she has a reputation for deft editing and pulling no punches when it comes to revisions.

Dr. Julie Overbaugh, a Fred Hutch HIV researcher, remembers a particular grant Linial reviewed for her early in Overbaugh’s career. “She just sat there and pretty much said, ‘Well, there’s this, and you could do this differently,’ and then she just looked up and said, ‘I would just start over,’” Overbaugh said. “She was absolutely right and the grant got funded when I did take her suggestion.”

Linial’s hallmark directness served her well as she established her research career and helped her mentees establish theirs. It carried over outside the lab as well — Linial learned to play soccer at age 40 to join a Fred Hutch/University of Washington female scientists’ team and was most valued for her aggressive stance as a defender.

“[My teammates] would say, ‘Well, you’re not very good, but you can play the whole game because you’re in good shape and you’re mean!’” she said. “If I didn’t get the ball at least I could snarl at the other team.”

But these days her candor is somewhat tempered, Galloway said. Linial says in part she’s not as self-assured since she can no longer read reactions on people’s faces. Additionally, much of her confrontational spirit was directed at fighting for women in science, an obstacle she feels has now been greatly overcome.

“I think what I did was helpful, because the Hutch has a lot of women now,” she said. “So I hope that I have created a good legacy here at the Hutch. But now I can sit back and let other people do some of these things.”